During Monday’s debate, CNN’s Wolf Blitzer asked whether an uninsured 30-year-old who had chosen to go without insurance should be left to die if he falls unexpectedly ill. Ron Paul dodged the question. … If you collapse on a street, an ambulance will rush you to a hospital. If you get into a car accident, you’ll wake up in intensive care. … Whether you get billed or your family gets billed or society gets billed, someone will pay the bill. … Even the hardest of libertarians has always understood that there are places where your person ends and mine begins. Generally, we think of this in terms of violent intrusion or property transgressions. But in health care, it has to do with compassion. We are a decent society, and we do not want to look in people’s pockets for an insurance card when they fall to the floor with chest pains.
But a great many ill, collapsed, etc. folks in the world are largely left to die, at least if curing them costs anything like a US hospital stay. Ezra argues above for “decent” national care, not global care. And even libertarians wouldn’t leave family members to die. So everyone agrees that we heroically help some, and leave others to die. We only disagree on who falls into which category.
I see key similarities between this and many responses to my recent posts, such as on 9/11, alien elites, or immigration. Such as: How can I not see that 9/11 deaths matter far more than most deaths, because this was them attacking our way of life? Or that alien elites secretly running our society, even running it well, must be exterminated though that would be unreasonable for human elites? Or that the richest big US county, Fairfax County, shouldn’t restrict immigration from poorer counties because we US folks are similar enough to each other?
Humans clearly evolved quite different mental modes for thinking about how to treat folks with our our local tribe, vs. how to treat distant strangers. Libertarians largely accept the usual ideas about how to treat both groups. Where they disagree is who counts as a stranger.
Libertarians limit “my tribe” to close family and small chosen communities, much as did our forager ancestors, who were free to change bands at any time. Farmer culture taught farmers to think of distant strangers as “my tribe”, as long as “our elites” said so, or if “we” fought wars together. And nation-states have worked hard over the last few centuries to transfer this feeling to nations. Libertarians mostly just don’t accept this. And though I’m not strictly libertarian, on this I agree – it is far from obvious that nations must be our tribes.
Now people usually try to be nicer to their tribe than to distant strangers. From this one might conclude that libertarians, who see more folks as strangers, are not as nice people. But not only are folks who see their tribe as smaller usually nicer to such insiders, libertarians also tend to be more accepting of mutually beneficial interactions with strangers. And economists make a pretty strong case that libertarian policies such as free immigration would greatly improve overall welfare.
As with Ezra’s comments above, most critiques of libertarian policy seem to miss this central point, by invoking standard ways to classify folks into “us” and “them.” To criticize libertarians effectively, you need to make clear why exactly “we” are a nation, rather than the entire world, or close family and friends. Alas, few critics even try to argue this point.
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